| アブストラクト | INTRODUCTION: Nephrologists have recently recognized the heterogeneity of kidney diseases among patients with diabetes and begun to actively perform percutaneous renal biopsies (PRBs). Nevertheless, the association between diabetes and major bleeding complications of PRB remains unclear. METHODS: In this retrospective cohort study using the Diagnosis Procedure Combination database in Japan, we identified patients who underwent an elective PRB from July 2010 to March 2018. The primary outcome was the occurrence of major bleeding complications, defined as red blood cell transfusion within 7 days after PRB or invasive hemostasis after PRB. Multivariable regression analysis was performed to analyze the association between diabetes and major bleeding complications with adjustment for patient and hospital characteristics. RESULTS: We identified 76,302 patients, including 8245 with diabetes. The proportion of PRBs performed for patients with diabetes continuously increased over time. Major bleeding complications occurred in 678 patients (0.9%), including 622 (0.8%) with red blood cell (RBC) transfusion and 109 (0.1%) with invasive hemostasis. Diabetes was significantly associated with major bleeding complications (relative risk [RR] = 2.41; 95% CI 2.00-2.90). Among patients with diabetes, multiagent or insulin treatment had significant association with major bleeding complications (RR = 1.57; 95% CI 1.18-2.10), compared with single-agent diabetes treatment. CONCLUSION: Diabetes is significantly associated with major bleeding complications of PRBs. Moreover, severity of diabetes has association with increases in major bleeding complications. Thus, nephrologists should carefully judge whether the anticipated benefits outweigh the relatively high risk of major bleeding complications when considering PRB for patients with diabetes. |
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| ジャーナル名 | Kidney international reports |
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| 投稿日 | 2022/2/15 |
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| 投稿者 | Hasegawa, Sho; Okada, Akira; Aso, Shotaro; Kumazawa, Ryosuke; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo; Nangaku, Masaomi |
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| 組織名 | Division of Nephrology and Endocrinology, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Division of Chronic Kidney Disease Pathophysiology, Graduate School of Medicine,;The University of Tokyo, Tokyo, Japan.;Department of Prevention of Diabetes and Lifestyle-Related Diseases, The;University of Tokyo Graduate School of Medicine, Tokyo, Japan.;Department of Biostatistics and Bioinformatics, Graduate School of Medicine, The;Department of Clinical Epidemiology and Health Economics, The University of;Tokyo, Tokyo, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University,;Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/35155862/ |
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